PRODUCT

WHAT DOES ULTIMATE GLUCOSAMINE DO?

ULTIMATE GLUCOSAMINE helps relieve joint pain associated with osteoarthritis and could be a factor in the maintenance of good cartilage and/or joint health.

WHAT IS ULTIMATE GLUCOSAMINE?

ULTIMATE GLUCOSAMINE is a powder consisting of 100% pure N-acetylglucosamine. This unique formulation contains no additives, salts, preservatives, colouring agents, gluten, lactose or yeast. It dissolves readily and can be added to any hot or cold beverage as a mild sweetener.

N-acetylglucosamine is a major component of hyaluronan, a substance that lubricant joints. It is important in the growth, and repair of joint cartilage and joint damage in experimental models of osteoarthritis1,4.

In addition, it has been shown to have anti-inflammatory properties in vitro. N-acetylglucosamine has been administered to children2 in amounts up to 6 grams per day for up to 2 years without any reported adverse effects.

Lack of adverse effects is likely explained by the fact that N-acetylglucosamine is a natural and important nutritional substance. Human breast milk3 contains as much as 1.5 grams per litre of milk and is the second most abundant sugar after lactose.

References
1       Shikhman AR, Amiel D, D’Lima D, Hwang SB, Hu C, Xu A, Hashimoto S, Kobayashi K, Sasho T, Lotz MK. Chondroprotective activity of N-acetylglucosamine in rabbits with experimental osteoarthritis. Ann Rheum Dis. 2005 Jan;64(1):89-94. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1755188/
2       Salvatore S, Heuschkel R, Tomlin S, Davies SE, Edwards S, Walker-Smith JA, French I, Murch SH. A pilot study of N-acetyl glucosamine, a nutritional substrate for glycosaminoglycan synthesis, in paediatric chronic inflammatory bowel disease. Aliment Pharmacol Ther. 2000 Dec;14(12):1567-79. http://www.ncbi.nlm.nih.gov/pubmed/11121904
3       Miller JB, Bull S, Miller J, McVeagh P. The oligosaccharide composition of human milk: temporal and individual variations in monosaccharide components. J Pediatr Gastroenterol Nutr. 1994 Nov;19(4):371-6. www.ncbi.nlm.nih.gov/pubmed/7876988
4        Chang N, Lin YT, Lin CC, et al. The repair of full-thickness articular cartilage defect using intra-articular administration of N-acrtyl-D-glucosamine in the rabbit knee: randomized controlled tial.  BioMed Eng OnLine 2015 14:105. http://www.ncbi.nlm.nih.gov/pubmed/26582033
HOW IS ULTIMATE GLUCOSAMINE DIFFERENT?

There are many glucosamine products on the market. Most are irrational combinations without any solid clinical or scientific basis to justify their use. This is not the case for ULTIMATE GLUCOSAMINE.

100% Pure N-acetyl-D-glucosamine >

ULTIMATE GLUCOSAMINE contains only 100% pure N-acetylglucosamine. Almost all marketed glucosamines are isolated from the shells of crustaceans, in which glucosamine is present as polymers of N-acetylglucosamine. Some isolation processes use strong acids that break down the polymer. Unfortunately, this also removes the N-acetyl group from N-acetylglucosamine resulting in a low-molecular-weight glucosamine molecule. If sulphuric acid is used, glucosamine sulphate, a sulphate salt results. Correspondingly, if hydrochloric acid is used, glucosamine hydrochloride, a chloride salt results. Our more gentle treatment and purification process yields the intact N-acetylglucosamine molecule.

Contains more biologically active ingredient >

ULTIMATE GLUCOSAMINE is free of additives, salts or preservatives, and contains more of the biologically active ingredient than other preparations. Most marketed glucosamine tablets and capsules contain the salt glucosamine sulphate and the stabilizer sodium or potassium chloride. However, the only biologically important ingredient is glucosamine. This is a weakness in products containing 500mg of glucosamine sulphate and possibly as little as 325mg of the critical component. In a recent study5 of glucosamine products, the majority of preparations contained less than 60% of the stated amount of glucosamine. With ULTIMATE GLUCOSAMINE there are no salts or additives, what you see is what you get.

More direct route to macromolecules >

ULTIMATE GLUCOSAMINE is the most direct route to the important macromolecules such as hyaluronic acid, keratan sulphate and chondroitin sulphate. Unlike the low-molecular glucosamine found in glucosamine sulphate or glucosamine hydrochloride, N-acetyl-D-glucosamine is an advanced molecule that requires fewer enzymatic steps before being incorporated into the macromolecules of cartilage.

No interference with glucose metabolism >

ULTIMATE GLUCOSAMINE does not interfere with glucose metabolism. Low-molecular glucosamine, as in glucosamine sulphate or glucosamine hydrochloride, has been associated with elevated blood glucose in patients6. This probably occurs because low-molecular-weight glucosamine and/or its break down product glucosone, inhibits hexokinase7. N-acetylglucosamine has its own kinase8, and is not dependent on glucokinase. Nor does it cause a rise in glucose levels when infused into humans9.

Convenient and tastes good >

ULTIMATE GLUCOSAMINE is available in a once-a-day powder dosage, making it one of the most convenient supplements to take. The N-acetylglucosamine molecule is more stable and, with a melting point of 205°C, it can be taken with hot beverages and used in baking. ULTIMATE GLUCOSAMINE is also sweet tasting, and can be used in hot beverages such as tea or coffee. Low-molecular-weight glucosamine salts have a melting point of only 88°C, are bitter and generally have an unpleasant taste. Glucosamine is unstable which results in both degradation products and condensation products.10

REFERENCES
5       Russell AS, Aghazadeh-Habashi A, Jamali F. Active ingredient consistency of commercially available glucosamine sulphate products. J Rheumatol. 2002 Nov;29(11):2407-9. http://www.ncbi.nlm.nih.gov/pubmed/12415601
6       Biggee BA, Blinn CM, Nuite M, Silbert JE, McAlindon TE. Effects of oral glucosamine sulphate on serum glucose and insulin during an oral glucose tolerance test of subjects with osteoarthritis. Ann Rheum Dis. 2007 Feb;66(2):260-2. Epub 2006 Jul 3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1798503/ 
7       Eeg-Larsen N, and Laland SG.  The effect of D-Glucosone on brain hexokinase and on liver glucose dehydrogenase. Acta Phys Scandinav 1954 30:295 – 301. http://www.ncbi.nlm.nih.gov/pubmed/13171110
8       Miwa I, Mita Y, Murata T, Okuda J, Sugiura M, Hamada Y, Chiba T. Utility of 3-O-methyl-N-acetyl-D-glucosamine, an N-acetylglucosamine kinase inhibitor, for accurate assay of glucokinase in pancreatic islets and liver. Enzyme Protein. 1994-1995;48(3):135-42. http://www.ncbi.nlm.nih.gov/pubmed/8589800
9       Gaulden EC, Keating WC. The effect of intravenous N-acetylglucosamine on the blood and urine sugar concentrations of normal subjects. Metabolism. 1964 May;13:466-72. http://www.ncbi.nlm.nih.gov/pubmed/14169225
10     Hrynets Y, Ndagijimana M and Betti M. Studies on the formation of Maillard and carmelization products from glucosamine incubated at 37ºC.  J.Agric. Food Chem 2015, 63:6249-6261. http://www.ncbi.nlm.nih.gov/pubmed/26114422
HOW TO TAKE IT

We recommend that your patients add 1 level teaspoon of ULTIMATE GLUCOSAMINE to any hot or cold drink including tea, coffee, juice, milk or soda. The once-a-day powder format can easily be adapted to their daily routine:

  • For a relaxing bedtime drink, add 1 teaspoon to a cup of camomile tea.
  • Add 1 teaspoon to their morning ritual, a smoothie or a cup of coffee.
  • Sprinkle 1 teaspoon over hot or cold cereal.
  • After any physical activity, add 1 teaspoon to a favourite energy drink.
USUAL DOSE

One level teaspoon

Most people take 1 level teaspoon (5 mL), or about 2 grams at a time. Others prefer to use more, especially when they first start taking ULTIMATE GLUCOSAMINE. Since the substance has no known toxicity, 2 to 3 teaspoons per day can be taken without any side effects.

The maximum dosage of N-acetylglucosamine has not been established because it is a food substance. However, here are some facts to guide your advice to patients:

Treatment of inflammatory bowel disease >

The University Department of Paediatric Gastroenterology at the Royal Free Hospital in London used N-acetylglucosamine at a total daily dose of up to 6 grams for up to 2 years.

Present in human breast milk >

N-acetylglucosamine is present in human breast milk at a concentration of 1.5 grams per liter. Since a newborn consumes about 600 milliliters of breast milk per day, the daily consumption of N-acetylglucosamine in an 8-pound infant is about 0.5 to 0.8 grams.

Rat Testing >

Rats have been fed diets in which N-acetylglucosamine constituted 5% of the total diet. In this 13-week trial, no toxicity was noted in any organ system.

HOW LONG BEFORE BENEFITS KICK IN?

Clinical trials that looked at symptoms of pain and discomfort, a therapeutic response was seen after at least 4 weeks of use. Other studies using this class of medication have shown that the pain relief equivalent to NSAIDs occurs after about 4 to 6 months of use. Trials that looked at harder endpoints, such as joint space narrowing, were much longer. These trials lasted for 3 years.

SAFETY

NO KNOWN INTERACTIONS

There are no known interactions with prescription medications.

SAFE FOR DIABETICS?

Yes. ULTIMATE GLUCOSAMINE is safe for diabetic patients.

While ULTIMATE GLUCOSAMINE is safe for diabetics, that is not the case with glucosamine sulphate and glucosamine hydrochloride. This is an emerging area, however, and no large-scale human trials are available. Here’s the published information currently available:

American College of Rheumatology, November 2005 >

An abstract of a paper presented at a meeting of the American College of Rheumatology in November 2005 suggests that in normoglycemic individuals, glucosamine salts do not present a clinical problem. In subjects with an abnormal oral glucose tolerance test, the average value went from 145 to 191 mg minute/ml when the glucosamine salt was co-administered. Individual data were not given. One of two subjects with an abnormal oral glucose tolerance test became diabetic on the co-administration of a single dose of glucosamine sulphate. However, this small study offers no basis for predicting the rates in a larger study11.

11       Biggee BA, Blinn CM, Nuite M, Silbert JE, McAlindon TE. Effects of oral glucosamine sulphate on serum glucose and insulin during an oral glucose tolerance test of subjects with osteoarthritis. Ann Rheum Dis. 2007 Feb;66(2):260-2. Epub 2006 Jul 3.

Pancreas Study >

A basic study of insulin release in the rabbit pancreas found that N-acetylglucosamine, at a concentration of 15 mg/mL, did not affect glucose-stimulated insulin release under high or low glucose conditions. In contrast, glucosamine hydrochloride, at a concentration of 4 mg/mL, inhibited glucose-stimulated insulin release under high-glucose conditions (3 mg/mL) but not under low-glucose conditions (0.6 mg/mL)12.

In humans, an infusion of 100 grams of N-acetyl-D-glucosamine did not result in an increase in blood glucose. Insulin injection did not alter the clearance of N-acetyl-D-glucosamine, suggesting that N-acetylglucosamine does not use the insulin-sensitive transporters used by glucose13.

12       Miwa I, Mita Y, Murata T, Okuda J, Sugiura M, Hamada Y, Chiba T. Utility of 3-O-methyl-N-acetyl-D-glucosamine, an N-acetylglucosamine kinase inhibitor, for accurate assay of glucokinase in pancreatic islets and liver. Enzyme Protein. 1994-1995;48(3):135-42. www.ncbi.nlm.nih.gov/pubmed/8589800
13       Gaulden EC, Keating WC. The effect of intravenous N-acetylglucosamine on the blood and urine sugar concentrations of normal subjects. Metabolism. 1964 May;13:466-72. http://www.ncbi.nlm.nih.gov/pubmed/14169225
DOES CHONDROITIN NEED TO BE ADDED TO MAKE GLUCOSAMINE EFFECTIVE?

No. According to the science, the benefits of chondroitin can be achieved by using additional glucosamine.

Combination products with chondroitin usually contain the same amount of glucosamine as the glucosamine-only product and, in addition, have 400 milligrams or more of chondroitin. Thus, the total amount of sugar amines consumed is almost doubled. We believe the same goals can be accomplished by giving more glucosamine.

What is Chondroitin? >

Chondroitin sulphate is a co-polymer of N-acetylgalactosamine and glucuronic acid. N-acetylgalactosamine is an epimer of N-acetylglucosamine (the –OH on carbon 4 is flipped in a different plane). All cells have epimerases, which can interconvert N-acetylglucosamine and N-acetylgalactosamine (meaning one -OH is flipped in a different plane).

Chondroitin is a high-molecular-weight polymer, which is not absorbed as an intact molecule14. Individual molecules of N-acetylgalactosamine and glucuronic acid are probably the largest units that are absorbed from the gut15.

Thus, the combination product glucosamine and chondroitin supplies more glucosamine equivalents (N-acetylgalactosamine or N-acetylglucosamine) than glucosamine-only products, with only half as much amine sugars.

14   Jackson C. G., A. H. Plaas, J. D. Sandy et al. (2010) The human pharmacokinetics of oral ingestion of glucosamine and chondroitin sulphate taken separately or in combination. Osteoarthritis Cartilage 18:297 –302. www.ncbi.nlm.nih.gov/pubmed/19912983
15  Liau, Y. H., N. Galicki, et al. (1981). “Degradation of chondroitin 4-sulphate by rat stomach exoglycosidases, sulfohydrolase and hyaluronidase-like enzymes.” Digestion 21(3): 117-24. http://www.ncbi.nlm.nih.gov/pubmed/6783467
GLUCOSAMINE CAN BE ABSORBED BY GUT WITHOUT BREAKDOWN

Glucosamine and N-acetylglucosamine are both absorbed from the gut intact16.

16   Tesoriere, G., F. Dones, et al. (1972). “Intestinal absorption of glucosamine and N-acetylglucosamine.” Experientia 28(7): 770-1. www.ncbi.nlm.nih.gov/pubmed/4658846